Training Hospital Research Articles

Implementation and outcomes of a dementia-friendly training program in five hospitals

Background: Hospitalized patients living with dementia (PLWD) age 65+ generally experience poor outcomes. This study's purpose was to implement dementia-friendly training with staff, track patient outcomes, and implement sustainable system changes.Methods: We conducted a prospective study in five hospitals. The hospitals adopted HealthCare Interactive's CARES® Dementia 5-Step Method for Hospitals Online Training and Certification Program . After on-line modules completion, a didactic session was offered, and a retrospective pre/post survey was completed. Patient falls, length of stay, and readmission rates were collected.Results: 1,836 (41 %) staff completed the training. Positive changes in staff ratings from pre- to post- intervention were observed. Number of falls and readmissions did not change. The average number of stays per patient decreased by .24 (p=0.01). Hospitals made system changes including innovative identification for PLWD.Conclusions: Dementia-friendly hospital training is effective in improving staff recognition of the symptoms and needs of PLWD, and responding appropriately.

From Technology Acceptance to Platform Attachment: Hospitality Training in Metaverse

ABSTRACT Evolving from augmented and virtual reality environments, the metaverse offers unique immersion, presence, interaction, and persistence, setting it apart from other online platforms. This study employs an experimental design to test a model examining how technology acceptance and platform attachment, driven by situatedness in the metaverse, impact learning in hospitality education. We propose a framework combining technology acceptance with place attachment theory to explore the metaverse’s role in hospitality training. Statistical analysis reveals a significant positive correlation between technology acceptance and platform attachment (β = 0.399, p < .001), which in turn positively influences mental model change (β = 0.758, p < .001). These findings highlight the metaverse’s transformative potential in hospitality education by influencing cognitive frameworks, specifically mental model changes, and enhancing task performance during virtual training. The study also identifies the mediating role of platform attachment in shaping user experiences, providing a theoretical basis for understanding the metaverse’s impact and practical insights for improving hospitality training.

The role of emergency medicine specialists and general practitioners in yellow zone patient management: A case in the Sakarya Province

AbstractBackgroundEmergency departments in Turkey employ both emergency medicine specialists (EMSs) and general practitioners due to an insufficient number of EMSs. Patients are triaged into green, yellow, and red codes based on urgency. Typically, EMSs manage more critical patients (yellow and red codes), while general practitioners handle less urgent cases (green codes).ObjectiveThis study investigates differences in patient management approaches between EMSs and general practitioners in the yellow zone of an emergency department in the Sakarya Province.MethodThis retrospective, cross‐sectional study was conducted at the Sakarya Training and Research Hospital from 31 December 2020 to 31 December 2021. The study included patients aged 18 and older who were assigned to the yellow zone and discharged by the attending physician. Data on patient monitoring times, consultation requests, hospitalization rates, resource utilization, readmission rates, and hospital revenue contributions were collected and analyzed. Statistical analyses were performed using IBM SPSS version 21, comparing the performance of EMSs and general practitioners.ResultThe study included 59 physicians (14 EMSs and 45 general practitioners) and a large number of patients. EMSs had significantly more experience, shorter consultation request times, and higher ICU admission rates. They also ordered fewer MRIs and USGs per patient and made more consultation requests. There was no significant difference between EMSs and general practitioners in terms of the number of examinations, patient observation times, ward hospitalization rates, CT orders, readmission rates, and hospital revenue contributions.ConclusionEMSs demonstrated more efficient use of emergency department resources, effective consultation processes, and higher ICU admission rates, indicating better patient management. Despite the limited scope of this single‐center study, the findings highlight the importance of EMSs in improving emergency care quality. Further research is needed to validate these results across multiple centers.

Assessing emergency physicians' competency gaps in caring for acute psychiatric emergencies: a comparative analysis of self-perceived confidence and performance against training program expectations

BackgroundThe increasing trend of patients with mental health conditions seeking emergency care is a global phenomenon. Numerous studies have emphasized the importance of emergency physicians' ability to recognize and manage psychiatric emergencies, both for patient well-being and societal safety nets. With the growing demand for emergency care related to mental health conditions, it is crucial to assess whether emergency physicians possess sufficient confidence and capabilities to adapt to these changes. Against this backdrop, our study aimed to explore the factors influencing emergency physicians' management of acute psychiatric emergencies and to critically evaluate whether current training programs adequately align with societal expectations for psychiatric emergency care.MethodsA cross-sectional survey, disseminated online by the Taiwan Society of Emergency Medicine, targeted 936 attending physicians and 449 residents in 43 Resident Review Committee approved training hospitals in winter 2021. The questionnaire covered participant demographics, skill requirements, and confidence in managing acute psychiatric patients independently. Statistical analyses included descriptive statistics, chi-square tests, medians (IQRs), and Wilcoxon rank-sum tests.ResultsOut of 229 participants, 63.8% were attending physicians, and 81.7% were affiliated with medical centers. Psychiatrists led 69.9% of emergency psychiatric training curricula, and 66.8% reported that their clinical psychiatric training outcomes were assessed by psychiatrists. Clinical seniority, training hospital level, and the average number of patients with an acute psychiatric presentation seen in a daily shift influenced physicians' self-reported confidence in managing acute psychiatric patients independently. Medical center training improved capability in managing psychiatric emergencies in the elderly, while encountering a higher average number of patients with an acute psychiatric presentation seen in a daily EM shift was associated with better performance, especially in managing specific populations.ConclusionsOur nationwide study highlights how clinical seniority, training hospital level, and patient volume per shift influence emergency physicians' confidence in managing acute psychiatric patients. However, there remains room for improvement, particularly in addressing the needs of specific patient populations. These findings underscore the importance of refining training curricula to bridge these gaps and enhance the quality of psychiatric emergency patient care.

Investigation of Body Perception, Alexithymic Characteristics, and Self-Esteem in Patients Underwent Septorhinoplasty.

Objective: This study evaluated patients' body perception, self-esteem, and personality traits during the preoperative and postoperative periods of septorhinoplasty. Based on these evaluations, we may provide patient selection recommendations for septorhinoplasty applicants. Methods: In this cross-sectional questionnaire study, 86 patients who underwent primary septorhinoplasty in the Department of Otolaryngology at Bilecik Training and Research Hospital were included between March 2023 and 2024. The same surgeon performed all operations. The preoperative Rhinoplasty Outcome Evaluation (ROE) Questionnaire, Rosenberg Self-Esteem Scale (RSES), Body Perception Scale (BPS), Toronto Alexithymia Scale (TAS), and TEMPS-A Temperament Scale in the preoperative period and ROE, RSES, and BPS in the postoperative period were applied. Results: Fifty-four female and 32 male patients participated in our study. The mean age was 24.0 ± 0.6 years. While there was no significant difference in the BPS and RSES scores between the preoperative and postoperative periods, the total ROE score was significantly higher in the postoperative than in the preoperative period. Postoperative ROE scores were positively correlated with RSES and hyperthymic temperament. In contrast, it was negatively correlated with depressive temperament, cyclothymic temperament, anxious temperament, BPS total score, TAS total score, and TAS emotion recognition and expression subscale scores. In the group with alexithymia features separated according to the TAS cutoff score, preoperative and postoperative ROE results were significantly lower, whereas depressive, cyclothymic, irritable, and anxious personality traits and total BPS scores were higher. However, the postoperative RSBE scores were lower in this group. Conclusion: This is the first study to evaluate self-esteem, body image, alexithymia, and personality traits in septorhinoplasty patients. Appropriate patient selection is essential for success and patient satisfaction in aesthetic operations such as septorhinoplasty. Performing BPS, TEMPS-A, and TAS may help evaluate psychological factors.

Assessment of imposter syndrome among postgraduate residents using Clance imposter phenomenon scale: a multicentric, cross-sectional study.

Imposter syndrome develops when high-achieving individuals, despite external measurements of achievement, have a chronic sense of self-doubt paired with a fear of being exposed as a hoax. This endangers one's mental health and well-being. The objective of the study was to determine the prevalence and severity of imposter syndrome among postgraduate residents and to identify the risk factors associated with imposter syndrome. This is a cross-sectional study conducted among the postgraduate trainees working in four different training hospitals in Pakistan. Imposter syndrome was assessed using the Clance Imposter Phenomenon Scale. A total of 146 postgraduate residents participated in this study. The majority had significant imposter syndrome, with females more suffered than males. Trainees of the pediatrics department were affected the most while of the dentistry were least to be affected. Multiple factors including marital status, number of children, working hours, extracurricular activities, and private practice have been shown to affect the prevalence of imposter syndrome. Imposter syndrome is a prevalent phenomenon among the residents of Pakistan. Efforts to identify and establish a proper relationship between general demographics and imposter syndrome are required for the healthy work experience of the trainees.

HCV genotype distribution in Istanbul: Adetailed 7 year epidemiological overview andimpact of Covid-19 pandemic.

Hepatitis C virus (HCV) is a leading cause of chronic liver disease, cirrhosis, and hepatocellular carcinomaworldwide. HCV has 8 genotypes (GT) and 86 subtypes and distribution of GTs varies based on geographical regions, transmission routes and even in cultural groups. The determination of viral genotype is crucial in choosing antiviral treatment, determining the duration of therapy, and monitoring treatment respose. Since 2014, with the usage of direct-acting antiviral agents (DAAs) in the treatment of HCV infections, a cure rate over 95% could be possible. Epidemiological data are important to combat a chronic HCV infections. Due to its geographical location, Turkey is like a bridge connecting Asia and Europe. Istanbul is the biggest and most crowded city of Turkey and has received immigration from many different countries, especially from Syria, in recent years and immigration still goes on. In addition, the COVID-19 pandemic has had devastating effects in our country. In this study, we determined the HCV genotypes in Health Sciences University Ümraniye Training and Research Hospital, in Istanbul between 2016 and 2022. Of the 322 patients analyzed during this 7-year period, HCV GT1b was the most prevalent GT in 65.2%, followed by GT3 in 15.5%, GT1a in 10.6%. Our data serve as a great mirror for HCV epidemiology in Turkey and contribute to global data.

Validity and Reliability Testing of the Turkish Version of the Self-Acceptance Scale for Pregnant Women

Objective: This study was conducted to adapt the Self-Acceptance Scale for Pregnant Women (SAS-PW), which was developed in Brazil, to Turkish and test the psychometric properties of its Turkish version. Method: This methodological study was carried out with 576 pregnant women who presented to the pregnancy outpatient clinics of a Research and Training Hospital in northern Turkey between December 2021 and April 2022. The validity of the Turkish version of SAS-PW was tested by conducting linguistic, content, and construct validity analyses, while its reliability was tested by conducting internal consistency and test-retest analyses. Results: According to the results of the exploratory factor analysis, the factor load values of the items and the rates of the total variance in scale scores explained by the factors were sufficient. The confirmatory factor analysis results demonstrated that the goodness-of-fit indices of the scale were within suitable ranges. The 2-factor and 10-item construct of the original SAS-PW was confirmed based on the factor analyses. The item-total score correlations of the scale were found sufficient, and the total Cronbach’s alpha coefficient of SAS-PW was determined to be 0.933. The test-retest analysis of the scale scores revealed a strong correlation between the scores of the two implementations. Conclusions: The Turkish version of SAS-PW is a valid and reliable measurement instrument to evaluate the self-acceptance levels of pregnant women in Turkish society.

Comparison of orexigenic and anorexigenic neuropeptide levels in hyperemesis gravidarum patients with normal pregnant women: A prospective cohort study.

The aim of this study was to determine whether orexigenic neuropeptides, orexin and galanin, and anorexigenic neuropeptides, alpha-melanocyte-stimulating hormone (α-MSH) and cocaine- and amphetamine-regulated transcript (CART), are implicated in hyperemesis gravidarum (HG). Fifty pregnant women who had been diagnosed with HG between April 2022 and February 2023 at the Siirt University Faculty of Medicine Training and Research Hospital (tertiary center) were recruited for this study. An equal number of pregnant women without an HG diagnosis were included in the study as the control group. Participants' age, pregnancy history, medical history, thyroid function test results, complete blood count results, and electrolyte levels were recorded, and their orexin, galanin, α-MSH, and CART serum levels were analyzed using an enzyme-linked immunosorbent assay. No statistically significant differences in orexigenic neuropeptides (orexin and galanin) were observed between the HG and control groups. A statistical difference was found between an anorexigenic neuropeptide (α-MSH) and the control group (P = .012). Based on a receiver operating characteristic analysis, the α-MSH parameter was statistically significant for distinguishing between participants with an HG diagnosis and those without, with a sensitivity of 63.6%, specificity of 65.9%, and cutoff value of 11769.3 pg/mL (P = .012, area under curve: 0.655). Based on the severity classification of ketonuria (ketonuria levels of +1 or +2 were classified as mild, whereas levels of +3 or +4 were classified as moderate to severe), the anorexigenic CART neuropeptide was found to be a statistically significant diagnostic indicator of severe ketonuria (P = .020). α-MSH and CART levels were found to be related in HG patients and in HG patients with severe ketonuria.

Rectal Cancer in Young Adults: A Single Center Experience.

Purpose: Individuals below the age of 40 make up only 3%-11% of colorectal cancer (CRC) cases. In this study, we aimed to review clinicopathological characteristics of rectal cancer in young adults. Methods: Rectal adenocancer patients aged ≤40 were included in this study from Antalya Training and Research Hospital. A single-arm descriptive study was designed. Results: There were 85 patients in the final analyses (n = 85). The median age was 37 (19-40). Mucinous adenocarcinoma and signet-cell carcinoma rates were 11.8% for each. Twenty patients (24.4%) had high-grade cancer. Fourteen patients (16.5%) had CRC history in a first-degree relative. None of the patients were diagnosed through a screening test. Of the 85 patients, 41 (48.2%) were stage 3 and 23 (27.1%) were stage 4 at the time of diagnosis. Thirty-four (54.8%) of the 62 nonmetastatic patients had neoadjuvant and 27 (43.5%) had adjuvant treatment because of having an upfront surgery before presentation. In the nonmetastatic population, the 5-year disease-free survival rate was 69.7 ± 6.5%. De-novo metastatic underwent chemotherapy, and biological agents were administered when feasible. KRAS mutation rate was 56.5% among metastatic patients. The median progression-free survival for the first-line treatment was 11.2 months (5.7-16.6), and the median overall survival was 22.3 months (15.4-29.1). Conclusion: We demonstrated that rectal cancer is usually diagnosed at late stages in young individuals which is compatible with the previous reports. Low cancer awareness in young patients and their caregivers and adverse histological features were advocated as the reason for the diagnostic delay. However, future studies may elucidate the reason behind the common diagnosis at advanced stages.

Diagnostic process of cancer in a health system without gatekeeping: a single centre survey analysis.

It is essential to increase the rates of early diagnosis in cancer control, and the diagnostic process needs to be improved to achieve this goal. Previous studies showed that in countries where there is a gatekeeping system, there might be a delay in cancer diagnosis. Our aim is to examine the process of cancer diagnosis in a healthcare system without gatekeeping. A quantitative descriptive study has been conducted in various outpatient clinics of Pendik Training and Research Hospital, between 1 February and 31 May 2019, with individuals aged over 18 and diagnosed with cancer in the last six months. The data was collected through a questionnaire filled in by face-to-face interview method. Patient's socio-economic characteristics, their symptoms at the time of the diagnosis and the diagnosis process were questioned. The median diagnostic interval was 30 days (min-max 1-365), and the median patient interval was 60 (1-600) days. Patients pointed out that the diagnostic tests, especially the pathology reporting process, caused the diagnostic interval to be prolonged. Of the patients, 84% (n 135) stated that they did not consider their symptoms as a sign of serious illness. The patient interval was shortest with symptoms of haematuria and haematochezia and longest with dysuria and change in bladder habit. The study examined the diagnosis process in our health system, where patients can apply for health services at any stage. The results showed that there were no superior outcomes to those observed in primary care-led health systems. Patients reported that waiting times for medical tests led to prolongation of the diagnosis time. Cancer awareness of patients should also be increased to shorten patient admission times.

Evaluation of Hospitalized Pediatric Patients in Terms of Anemia: Single-Center Experience

Introduction: Anemia, characterized by reduced hemoglobin and hematocrit levels, affects roughly one-third of the global population and is associated with increased morbidity and mortality. Iron deficiency anemia (IDA) is the most common form, particularly prevalent during childhood, a period of rapid growth. This study aimed to assess the frequency of anemia in pediatric patients hospitalized for various reasons. Material and methods: This study was conducted at SBU Bakırköy Dr. Sadi Konuk Training and Research Hospital, Department of Pediatrics, from September 1 to November 30,2021. The records of pediatric patients treated during this period were retrospectively reviewed. Patients with hematologic diseases were excluded from the study. Demographic data and laboratory results were recorded, and patients were grouped by age (0-2, 2-6, 6-12, 12-17 years) to compare laboratory values across these groups. Results: The study included 100 children, with an equal distribution of 50 girls (50%) and 50 boys (50%), hospitalized between September 1 and November 30, 2021, at SBÜ Bakırköy Dr. Sadi Konuk Training and Research Hospital. The patients' ages ranged from 1 month to 16.2 years, with a mean age of 3.34±3.90 years. The majority (59%) of patients were in the 0-2 age group, followed by 19% in the 2-6 age group, 19% in the 6-12 age group, and 3% in the 12-17 age group. It was observed that 31% of patients had chronic diseases. Hemoglobin levels were measured at 11.11±1.84 g/dL, hematocrit at 33.71±4.85%, mean corpuscular volume (MCV) at 81.35±8.48 fL, red cell distribution width (RDW) at 15.08±2.67%, iron (Fe) at 64.70±38.89 g/dL, ferritin at 228.50±200.04 μg/L, vitamin B12 at 554.83±389.46 ng/L, and folate at 11.34±6.23 ng/L. Conclusions: Anemia is a prevalent issue during childhood in our country and should be carefully considered in hospitalized pediatric patients. Upon detection, a cause-specific treatment plan must be developed to address this condition effectively.

Challenging Childhood Obesity: The Influence of Education and Close Monitoring on Obesity-Related Behaviors.

We aimed to evaluate the role of nutrition and behavior education intervention in the prevention and treatment of childhood obesity by comparing changes in obesity-related characteristics among obese children during a follow-up period of 12 months. This study was designed as a prospective cohort study in children aged between 6 and 18 years, with exogenous obesity who applied to Istanbul Research and Training Hospital, Pediatrics Department, between January 2018 and July 2019. Beginning at the sixth month, a program for nutrition and behavior education for obesity prevention and treatment was initiated and continued during the second half of the study period. The mean age of 59 children (29 females, 30 males) was 11.73 ± 2.78. BMI levels did not show a significant difference in the first 6 months, but decreased significantly during the second 6 months of the study. Screen time, fast eating behavior, overeating behavior and food score index scores also demonstrated significant improvements during the intervention period of the study, between 6 and 12 months. It was concluded that nutrition and behavior education for the prevention and treatment of childhood obesity could be a successful intervention with close follow-up.

Analysis of Birth Statistics, Examination of Caesarean Rates and Caesarean Indications; Retrospective Study

Purpose This study investigated cesarean delivery rates and indications for cesarean delivery among patients who gave birth in our clinic between 2019 and 2022. Materials and Methods For the study, the data of 16,559 patients who gave birth between 2019 and 2022 in the Obstetrics and Gynecology clinic of a Training and Research Hospital were retrospectively analyzed. The mode of delivery, gender information, fetal birth weight, vaginal delivery, and cesarean section rates and indications for cesarean section were analyzed. Results Among the patients who gave birth in our clinic between January 01, 2019, and December 31, 2022, 58.1% delivered vaginally, and 41.9% delivered by cesarean section. According to the four-year average, 48.5% of the babies born were girls, and 51.5% were boys. The most common indication for cesarean section was previous uterine surgery. The rate of primary cesarean section among cesarean deliveries was 47%. The most common indications for primary cesarean section were fetal distress, breech presentation, and non-progressive labor. Conclusion In our clinic, the four-year average cesarean delivery rate was 41.9%. Although this rate is below the national average of 53%, it is above the Ministry of Health's target rate of 35% in Turkey. When evaluated specifically for our province, we think this is mainly due to the lack of obstetrician-gynecologists in the districts and the high number of referrals to our hospital. Nevertheless, considering these results, it is clear that more comprehensive studies are needed to reduce cesarean section rates.

The effectiveness of liver function tests in the prediction of mortality in patients with COVID-19

Objective: To evaluate the impact of liver function test abnormalities on mortality in critically ill coronavirus disease-2019 patients. Method: The single-centre, retrospective study was conducted at the Department of Anaesthesiology and Reanimation, Mersin City Training and Research Hospital, Turkiye, and comprised data from March 2020 to January 2022 of patients with positive real-time reverse transcription polymerase chain reaction test on nasopharyngeal swab sample for coronavirus disease-2019. Comorbidities, demographic data, admission to and discharge from the intensive care unit, Acute Physiology and Chronic Health Evaluation II scores, complete blood count on the first and second day of hospitalisation, coagulation parameters, biochemical analysis, 7-day, 28-day and total mortality of the patients in the intensive care unit were recorded. The patients were then divided into groups, with Group 1 having patients with normal liver enzymes, Group 2 having patients with abnormal liver enzymes, and Group 3 having patients with liver damage. Data was analysed using SPSS 20. Results: Of the 940 subjects, 587(62.4) were males and 353(37.6) were females. The overall mean age of the patients was 67.11±16.65 years. There were 395(42%) patients in Group 1, 534(56.8%) in Group 2 and 11(1.2%) in Group 3. Gamma-glutamyl transferase-1s, aspartate aminotransferase-2nd and albumin-2nd were significant predictors of mortality (p&lt;0.05). Conclusion: High gamma-glutamyl transferase, aspartate aminotransferase and low albumin levels in critically ill coronavirus disease-2019 patients could be considered indicators of high mortality rate. Key Words: Coronavirus, Critical illness, Liver function test, Pandemic.

Developing and piloting a set of quality-of-care indicators for Romanian public hospitals as part of a national programme to fund quality

BackgroundHealthcare systems aim to enhance the health status and well-being of the individuals and populations they serve. To achieve this, measuring and evaluating the quality and safety of services provided and the outcomes achieved is essential. Like other countries, Romania faces challenges regarding the quality of care provided in its public hospitals. To address this, the Romanian Ministry of Health initiated reforms in 2022, including implementing a pay-for-performance model based on quality indicators. This paper presents a descriptive analysis of processes, methods, results and lessons learned from developing and piloting a set of Quality of Care indicators for Romanian public hospitals.MethodsWorld Health Organization’s Athens Office on Quality of Care and Patient Safety assisted Romania in developing and piloting a set of quality-of-care indicators for public hospitals. The development phase included defining indicator domains, identifying potential indicators across these domains, and defining the final indicator set. The piloting phase involved selecting and recruiting piloting hospitals, developing data collection and validation methods and tools, training hospital staff, and collecting and analysing indicator data. Piloting ended with an evaluation workshop. Mixed, quantitative and qualitative methods were used, including literature reviews, stakeholder consultation workshops, survey instruments developed for this study, modified Delphi panels and consensus-building meetings. National stakeholders were actively involved throughout the process.ResultsFour priority domains were defined for quality-of-care indicators for Romanian public hospitals: patient safety, patient experience, healthcare workforce training and safety, and clinical effectiveness. 25 core indicators were selected across these domains. During the pilot, hospitals achieved an average completion rate of 90% for data submission, with all domains rated equally relevant during post-pilot evaluations. Lessons included the need for supportive legislation, improved internal auditing practices and enhanced staff training, refinement of indicator data collection methods and alignment of indicators with hospital-specific contexts.ConclusionsThis work presents a significant stride in improving Romanian public hospitals’ quality of care and patient safety. It underscores the importance of high-level commitment, stakeholder engagement, and robust data practices in driving successful quality improvement efforts. Emphasising the role of data-driven and patient-centric approaches in achieving optimal healthcare outcomes, lessons learned offer insights for the continuation of quality improvement work in Romania but also for healthcare systems elsewhere.

Prediction model for early diagnosis of late-onset sepsis in preterm newborns.

Late-onset neonatal sepsis has a high mortality rate in premature infants. To date, no single test in the evaluation of neonatal sepsis has been demonstrated to be both sensitive and specific enough to assist in timely decision making. The aim of our study is to develop a predictive model that can be applied to all premature babies, using clinical and laboratory findings in premature babies, to recognize late-onset neonatal sepsis. 65 premature patients diagnosed with culture-proven late-onset neonatal sepsis and hospitalized in Dr. Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital neonatal intensive care unit between January 2018 and December 2020, and 65 premature newborns of similar age and gender who did not have sepsis were included in the study retrospectively. In our study, feeding difficulties, worsening in clinical appearance and fever were found to be significant among clinical findings, while thrombocytopenia and high C-reactive protein among laboratory findings are the strongest data supporting late-onset neonatal sepsis. In multiple regression analysis, thrombocytopenia, mean platelet volume, C-reactive protein, lymphocyte count and feeding difficulties had the highest odds ratio (p < 0.05). By converting these data into a scoring system, a nomogram was created that can be easily used by all clinicians. In our study, we developed a scoring system that can be easily applied to all premature patients by evaluating the clinical and laboratory findings in late-onset neonatal sepsis. We think that it will help in recognizing late-onset neonatal sepsis and strengthening the treatment decision. Predicting the individual probability of sepsis in preterm newborns may provide benefits for uninfected newborns to be exposed to less antibiotics, not to be separated from mother and baby, and to reduce healthcare system expenditures. The nomogram can be used to assess the likelihood of sepsis and guide treatment decision.

Radiation information, protection and awareness of healthcare professionals in terms of occupational health and safety: a two–center survey study

Abstract The objective of this study was to assess the level of knowledge, protection and awareness of radiation among healthcare professionals. A total of 413 healthcare professionals from two major training and research hospitals in Istanbul took part in the study. The sample consisted of 26.6% physicians and 73.4% other healthcare professionals. There was considerable variation in the knowledge of radiation content in imaging techniques, with correct response rates of 89.3% for Computed Tomography, 80.1% for digital x-ray, and 52.8% for Magnetic Resonance Imaging. While 69.5% of respondents provided correct answers to questions regarding radiation protection principles, 64.4% demonstrated a lack of sufficient knowledge in this area. It is noteworthy that 48.4% of respondents incorrectly identified the medical imaging technique to which the public is most exposed. It was concluded that further training on radiation-related issues should be provided at the university level and through in-service training for healthcare professionals.

T2-weighted spoiled gradient echo MRI for forensic age estimation: a study on knee growth plates.

The timing of growth plate fusion is a key indicator for age estimation and is primarily used in forensic investigations. On the other hand, non-ionizing techniques such as MRI are being developed to provide safer and more ethical evaluations in forensic casework. This study aims to evaluate the closure process of growth plates in the distal femoral and proximal tibial epiphyses using Multiple Echo Recombined Gradient Echo (MERGE) MRI sequences and provide age estimation data based on staging methods for forensic purposes. We retrospectively analyzed 559 patients (294 males, 265 females, aged 8-25 years) diagnosed with trauma and knee pain at Tepecik Training and Research Hospital from 2016 to 2019. MRI scans were performed using a 1.5-T system with MERGE sequences and evaluated by two observers using a new staging system. Observer agreement was assessed using Cohen's κ test, yielding high agreement values (κ > 0.8). Positive correlations were found between age and ossification stages (p < 0.001). Minimum age thresholds for stages 5a and 5b of the distal femoral epiphysis were 16 and 18 years for females and 17 and 19 years for males, respectively. For the proximal tibial epiphysis, the minimum ages for stages 5a and 5b were 15 years for females and 17 years for males. The MERGE sequence provides a viable method for assessing skeletal maturity in living individuals with significant ethical advantages due to non-ionizing radiation. This study supports the potential application of the MERGE sequence in forensic age estimation, demonstrating high observer agreement and consistency. Future research should focus on comparing different sequences and populations to enhance the methodology's applicability.

Obturator Nerve Block Performed Blinded Versus by Ultrasound-guidence for Transurethral Resection of Bladder Tumors: A Randomized Controlled Trial.

The primary outcome of this study is to compare the success rates of ONB techniques performed either with ultrasound guidance or with the blind technique. The second outcome is to compare the incidences of perioperative bleeding and the presence of recurrent tumors in the control cystoscopy performed in the 3rd postoperative month in both groups. The study was conducted in the urology operating room of Mugla Sitki Kocman Training and Research Hospital between December 2019 and March 2023. A total of 122 patients were included in the study: 22 females with a mean age of 56.63 ± 12.99 years and 100 males with a mean age of 63.18 ± 8.00 years. In one group (group 1), ONB was performed under ultrasound guidance by the same anesthesiologist, and in another group (group 2), ONB was performed blindly based on anatomical signs by the same urologist. Adductor muscle contraction was not observed in 53 patients (91.4%) in group 1 and in 49 patients (76.6%) in group 2 (p = 0.027). The success rate of ONB was higher when using an ultrasound-guided technique than when using a blind technique.